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Yellow Pages
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Yellow Pages
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Written by TAC Staff: Yellow Pages
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Sunday, 01 April 2012 19:33 |
 Tallahasse, FL Gov. Rick Scott scored a huge victory when the Florida Senate signed off on a last-ditch effort to crack down on personal injury protection fraud.
But the vote elicited rebukes from some senators who wanted the upper chamber to stand its ground and refuse to concur with the proposal – crafted largely by insurance industry lobbyists – in a debate highlighted by a stemwinder by Sen. Miguel Diaz de la Portilla, R-Miami.
Diaz de la Portilla, a lawyer, repeatedly called the deal a “phoney baloney” attempt to combat fraud. Diaz de la Portilla had convinced the Senate in its version of the PIP reform to keep intact “multipliers” allowing lawyers to be paid escalated fees. The compromise did away with that but, in a concession to the Senate, did not cap attorneys’ fees or set an hourly rate.
Growing more incensed as his rant went on, Diaz de la Portilla said that PIP scams aren’t the real fraud.
“I think the House measure that’s been sent over to us and that we’re being asked to concede to, that’s the fraud. It’s a fraud on the consumers of the state of Florida. It’s a fraud on the people who have to buy these policies by law. It’s a fraud on those who are injured in accidents. It’s a fraud because it basically is the Insurance Company Relief Act of 2012. That’s what it is. That’s exactly what we’re talking about,” Diaz de la Portilla said
Sen. Dennis Jones, a Seminole chiropractor who said he is probably the only senator who actually treated a PIP patient, called the bill a “very, very punitive” measure for chiropractors. Patients will now be limited to $2,500 worth of chiropractic treatment, a change from the 24 visits over three months now allowed.
Sen. Joe Negron, the Stuart Republican who brokered the deal for the Senate and sponsored the chamber’s trial lawyer-friendlier proposal, rejected his colleague’s criticism that the Senate would be giving up too much by taking the House offer. Negron then defended his efforts to keep chiropractors in the mix at all.
“The House wanted to take chiropractors, tie two 50-pound cement blocks to their ankles and drop them over the boat into the bottom of the ocean. And they were never going to be heard from in PIP again. I found that very offensive,” Negron, a lawyer, said.
Chief Financial Officer Jeff Atwater, a former Senate president who pushed alongside Scott for the overhaul, called Senate critics “dead wrong” about the deal.“The Senate got all its fraud language. The Senate got all its licensure language. The Senate got room for chiropractic care. The Senate did not cap attorneys fees. The Senate did a fine job. The House was very firm on driving the cost drivers of utilization down. They came together with a really solid compromise,” Atwater said.
Atwater said he’s certain premiums will decrease although the bill does not require it.
“I think they’re going to see when that independent study comes down that they’re going to indicate rates need to be coming down. They need to come down now,” he said.
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Yellow Pages
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Written by TAC Staff: Yellow Pages
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Sunday, 01 April 2012 19:28 |
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HAUPPAUGE, N.Y., -- Allstate Insurance Company has filed its first insurance fraud lawsuit of 2012, seeking to recover $2 million dollars against 27 New York area defendants. The Complaint names multiple physicians, chiropractors, medical professional corporations, and clinic lay-owners allegedly used to control the medical professional corporations, including 18 individual defendants currently under federal indictment.
The complaint alleges that New York medical professional corporations known as St. John Medical Care, P.C., Lenox Wellcare Medical, P.C., CB Chiropractic, LLC, New Age Orthopedic Rehabilitation, P.C., First Aid Medical Care, P.C., Rosedale Medical, P.C., TDL Medical, P.C., LDT Medical, P.C., and West End Chiropractic, P.C., were fraudulently incorporated through a scheme using the names of licensed medical physicians and chiropractors, and that lay-owners, none of whom were physicians, secretly owned and controlled the professional corporations.
The lawsuit was filed following an investigation by Allstate's Special Investigative Unit and seeks reimbursement for no–fault benefits Allstate paid on behalf of its customers during timeframes specified in the lawsuit. The lawsuit is the latest in a string of actions taken by the insurer to protect consumers from these and similar activities. Since 2003, Allstate has filed 37 fraud lawsuits in New York State seeking more than $ 201 million in damages.
According to the Insurance Information Institute, the state of New York is in an insurance fraud crisis and no-fault fraud is costing New Yorkers millions of dollars year-after-year in higher premiums. "In essence, honest, hardworking New Yorkers are paying a 'fraud tax,'" said Krista Conte, spokesperson for Allstate's New York office. "We need lawmakers to enact meaningful insurance reform that puts the citizens of New York first."
Source: PR Newswire
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Yellow Pages
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Written by TAC Staff: Yellow Pages
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Friday, 16 March 2012 23:11 |
On the campaign trail, GOP presidential candidate Rick Santorum says he will push to limit payments to victims in medical malpractice lawsuits, which he blames for unnecessarily driving up health-care costs. And over the course of his two decades in politics, he repeatedly spoke in favor of capping such awards.
But Santorum testified in support of his wife when she filed a medical malpractice suit in 1999 that sought $500,000, twice the cap in his 1994 legislative proposal. Karen Santorum claimed that a Fairfax chiropractor had left her with a permanent back injury that probably would result in a lifetime of pain medication and restricted mobility.
This fall, while campaigning in Iowa, Santorum told reporters that he backed some limits but that his wife did not sue for “pain and suffering, which is the area I think we should cap.”
Although the lawsuit did not seek a specific figure for pain and suffering, the former senator testified in the case about the emotional and physical toll on his wife and how that justified a sizable monetary award, transcripts show. The judge in the case also made clear that the majority of the $350,000 the jury awarded the family was largely for unspecific losses and pain and suffering, an amount he concluded was “excessive.”
The lawsuit stemmed from a family tragedy, when in 1996 Karen Santorum gave birth prematurely to the couple’s fourth child, a son who died the same day. Suffering lower-back pain after the delivery, Karen Santorum sought out a Burke chiropractor, David Dolberg, for help.
Dolberg performed a spinal manipulation, which he and other experts testified was a standard, recommended therapy for her symptoms. Karen Santorum said that the treatment caused a herniated disk in her spine, which was surgically removed a week later.
Brewster Rawls, Dolberg’s attorney in the suit, defended his client. “The medical evidence was clear that Mrs. Santorum suffered no serious injury,” Rawls said. “Quite simply, the outcome of this case — even with the trial court reducing the verdict by 50 percent — was entirely unfair to this good doctor.”
The Santorums unsuccessfully sought to seal the records in the lawsuit against Dolberg and the center where he worked, saying her husband’s role as a senator would draw attention to the case and violate his wife’s privacy.
Source: Washington Post
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Yellow Pages
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Written by TAC Staff: Yellow Pages
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Friday, 16 March 2012 23:05 |
Ocoee, FL: An Ocoee man faces multiple felony charges in a suspected fraud scheme that authorities say bilked health insurance providers out of thousands of dollars in improper or phony claims.
An investigation by the state's Department of Financial Services resulted in the arrest ofJean Ely Colin, who is identified in court documents as manager of Silver Star Health and Rehab Inc.
Investigators say Colin, 43, who court records state is not a licensed physician, conspired to get around state regulations requiring chiropractic clinics to be operated by a licensed doctor.
He listed a licensed chiropractor, Judith C. McKenzie, in incorporating documents as the clinic's owner, but investigators say she wasn't involved in day-to-day operations or management.
Rather, the business on Silver Star Road was run by Colin and co-defendant Marc Maxis, investigators said. According to court records, McKenzie had similar arrangements at other clinics.
A clinic employee also told DFS investigators that Colin often told him to falsify various documents and patient records, generating reports for patients that were not treated by the clinic.
According to court documents, the clinic improperly billed various major insurance companies, including State Farm, Allstate, Farmers and Progressive, to the tune of more than $550,000.
Colin faces charges of organized scheme to defraud, operating an unlicensed health care clinic, false and fraudulent insurance claims and grand theft. All of the charges alleged are felonies.
Colin was arrested on a warrant Wednesday. He has since been released after posting bail.
Source: The Orlando Sentinel, Fla.
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Yellow Pages
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Written by TAC Staff: Yellow Pages
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Wednesday, 29 February 2012 15:38 |
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Bluffton, FL: A 57-year-old former Bluffton chiropractor has pleaded no contest to charges of sexual abuse of a minor in Florida and will face similar charges in South Carolina involving the same girl.
Raymond Anthony Delgado sexually abused the girl while she was staying with him during a summer vacation in Bluffton and during his visits to her family in St. Johns County, Fla., according to the Bluffton Police Department and the St. Johns County Sheriff's Office.
He pleaded no contest Thursday to two of the 10 child sex charges, both felonies, filed against him in St. Johns County, according to Florida's 7th Judicial Circuit Court.
He faces up to 25 years in prison, according to state attorney public information officer Klare Ly.
Those charges were filed after Delgado had already been jailed in St. Johns County on Sept. 3, 2010. Delgado, who was living in the Westbury Park neighborhood in Bluffton at the time, was arrested in Florida at a place he and the girl had agreed to meet, the St. Johns Sheriff's Office has said.
Delgado would travel to St. Augustine to spend time with the girl and her father, but that "was a guise to continue sexually abusing and molesting the child," according to a news release from the Florida court.
"The defendant took advantage of his relationship with a child who trusted him," said Florida state attorney R.J. Larizza. "There are few -- if any -- crimes more sinister than that."
Source: The Beaufort Gazette
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